Systems and processes for inserting an intraocular lens

ABSTRACT

Various systems and techniques for inserting an intraocular lens are disclosed. In particular implementations, a system and a technique for inserting an intraocular lens may include the ability to move, in response to a force being applied in a first direction along a longitudinal axis, a first plunger tip along the longitudinal axis and into a delivery cartridge to fold an intraocular lens and move in a second direction along the longitudinal axis in response to the applied force being reduced. The system and the technique may also include the ability to engage a second plunger tip and move, in response to a force being applied in the first direction along the longitudinal axis, the second plunger tip along the longitudinal axis and into the delivery cartridge to insert the intraocular lens.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.61/774,379 filed Mar. 7, 2013, the entire contents being incorporatedherein by reference.

BACKGROUND

The present disclosure relates to optical surgery, and more specificallyto surgery for replacement of a patient's lens.

The human eye, in simple terms, functions to provide vision bytransmitting and refracting light through a clear outer portion calledthe cornea and focusing the image by way of the lens onto the retina atthe back of the eye. The quality of the focused image depends on manyfactors including the size, shape, and length of the eye, and the shapeand transparency of the cornea and lens.

When trauma, age, or disease causes the lens to become less transparent,vision deteriorates because of a reduction in light transmitted to theretina. This deficiency in the eye's lens is medically known as acataract. The treatment for this condition is often surgical removal ofthe lens and implantation of an artificial lens, often termed anintraocular lens (interchangeable referred to as “IOL”).

An IOL is often foldable and inserted into the eye through a relativelysmall incision by being advanced through an insertion cartridge, whichcauses the IOL to fold. The IOL is typically advanced through theinsertion cartridge by a plunger-like device.

SUMMARY

Various preload IOL delivery systems and techniques for inserting anintraocular lens are disclosed. In one general implementation, a systemfor inserting an intraocular lens may include a plunger, a plungerchamber, a plunger tip chamber, a lens chamber, and a deliverycartridge. The lens chamber may be adapted to receive an intraocularlens, and the delivery cartridge may be coupled to the lens chamber andadapted to fold and compress an intraocular lens as it is movedtherethrough. The plunger tip chamber may be adapted to house a firstplunger tip and a second plunger tip and to switch between the plungertips that may engage the plunger and an intraocular lens. In certainimplementations, the first plunger tip has a first hardness and thesecond plunger tip has a second hardness, and the hardness of the firstplunger tip is substantially greater than the hardness of the secondplunger tip. The plunger may be adapted to be manipulated by a user, andthe plunger chamber may be adapted to allow the plunger to be movedtherein along a longitudinal axis and move a plunger tip along thelongitudinal axis.

In certain implementations, the plunger tip chamber may be adapted toalternatingly switch between alignment of the first plunger tip with theplunger and alignment of the second plunger tip with the plunger. Theplunger tip chamber may, for example, alter which plunger tip is alignedwith the plunger by being laterally moveable so as to alternatinglyalign the first plunger tip with the plunger and the second plunger tipwith the plunger. The plunger tip chamber may, for instance, include acassette adapted to hold the first plunger tip and the second plungertip and to move laterally within the plunger tip chamber to alignalternatingly the first plunger tip and the second plunger tip with theplunger. In particular implementations, the cassette may be adapted tolock into a first position in which the first plunger tip is alignedwith the plunger and to lock into a second position in which the secondplunger tip is aligned with the plunger.

The plunger tip chamber may also include a spring adapted to compresswhen the first plunger tip advances. The spring may be adapted toretract the first plunger tip and the plunger when the first plunger tipis released.

In some implementations, the plunger is adapted to engage the firstplunger tip via abutting contact. In some implementations, the plungeris adapted to engage the second plunger tip via an interlockingrelationship. In particular implementations, the lens chamber may beadapted to prevent advancement of the first plunger tip beyond apredetermined distance. The predetermined distance may correspond to adistance associated with substantially folding an intraocular lens.

The system may also include an insertion tip coupled to the deliverycartridge. The insertion tip may be adapted to be inserted in an eye forinjection of a folded, compressed intraocular lens. The insertion tipmay be made from a different material and coupled or overmolded to thedelivery cartridge.

In one general implementation, a process for inserting an intraocularlens may include moving, in response to a force being applied in a firstdirection along a longitudinal axis, a first plunger tip along thelongitudinal axis and into a delivery cartridge to fold an intraocularlens and moving in a second direction along the longitudinal axis inresponse to the applied force being released. The apparatus performingthe moving function may, for example, be a plunger. The process may alsoinclude engaging a second plunger tip and moving, in response to a forcebeing applied in the first direction along the longitudinal axis, thesecond plunger tip along the longitudinal axis and into the deliverycartridge to compress the intraocular lens.

In some implementations, moving in a second direction along thelongitudinal axis in response to the applied force being released mayinclude returning the first plunger tip to a plunger tip chamber. Incertain implementations, engaging a second plunger tip may includealtering which plunger tip is aligned with the longitudinal axis.

In particular implementations, altering which plunger tip is alignedwith the longitudinal axis may include laterally moving the firstplunger tip from being aligned with the longitudinal axis and aligningthe second plunger tip with the longitudinal axis. Laterally moving thefirst plunger tip from being aligned with the longitudinal axis andaligning the second plunger tip with the longitudinal axis may, forexample, include laterally moving a cassette adapted to hold the plungertips. The process may also include locking the cassette in a position inwhich the second plunger tip is aligned with the longitudinal axis.

In certain implementations, moving in a second direction along thelongitudinal axis in response to the applied force being reduced mayinclude decompressing a spring.

The process may also include stopping movement of the first plunger tipin the first direction after the first plunger tip has traveled apredetermined distance.

Various implementations may have one or more features. For example, bybeing able to use plungers in sequence, a relatively hard tip plungerand a relatively soft plunger tip may be used to first appropriatelyfold an intraocular lens and still compress it sufficiently to fitthrough a small tip with little to no damage. Thus, the benefits of botha hard-tip plunger and a soft-tip plunger may be realized at the sametime to reduce tip size and meet the demanding performance requirementsof micro-incision cataract surgery.

Various other features will be apparent to those skilled in the art fromthe following description and the accompanying figures.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a perspective view of an example system for compacting anintraocular lens.

FIG. 1B is a cross-sectional side view of an example system forcompacting an intraocular lens.

FIG. 1C is a cross-sectional view of a distal end of an example systemfor compacting an intraocular lens.

FIG. 1D is a cross-sectioned side view of a portion of an example systemfor compacting an intraocular lens.

FIG. 2 is a cross-sectional side view of an example system forcompacting an intraocular lens in which a first plunger tip is extendedby a plunger.

FIG. 3 is a cross-sectional side view of an example system forcompacting an intraocular lens in which the first plunger tip isretracted.

FIG. 4 is a cross-sectional side view of an example system forcompacting an intraocular lens in which a second plunger tip is alignedwith a plunger.

FIG. 5 is a cross-sectional side view of an example system forcompacting an intraocular lens in which the second plunger tip ispartially extended.

FIG. 6 is a cross-sectional side view of an example system forcompacting an intraocular lens in which the second plunger tip issubstantially fully extended.

FIGS. 7A-7B are transverse cross-sectional views of a plunger chamber ofan example system for compacting an intraocular lens.

FIG. 8 is a flowchart illustrating an example process for compacting anintraocular lens.

DETAILED DESCRIPTION

FIGS. 1A-1D illustrate an example system 100 for compacting an IOL 102.IOL 102, which is typically composed of silicone, soft acrylics,hydrogels, or other appropriate materials, is advanced through system100 in preparation for insertion into the eye. In some instances, an IOL102 may, for example, be approximately 13 mm in diameter and may includehaptics 103. Surgical incisions may be much smaller (e.g., 0.5-3 mm inwidth). The IOL is therefore typically compacted (e.g., folded andcompressed) before insertion through the incision.

In general, system 100 includes a plunger 110 and a housing 120. Plunger110 is manipulable by a user to advance IOL 102 through housing 120.During this advancement, IOL 102 is folded and compressed for injectioninto an eye. Plunger 110 and housing 120 may generally be made of hardplastic or any other appropriate material.

In more detail, plunger 110 includes a body 112 and a user interface114. Housing 120 includes a plunger chamber 130, a plunger tip chamber140, a lens chamber 150, a delivery cartridge 160, and an insertion tip170, which may be integrally formed with each other. Housing 120 has alongitudinal axis 121 along which plunger 110 and various components ofhousing 120 move.

In the illustrated implementation, body 112 of plunger 110 is generallyelongated and is cylindrical in the illustrated implementation. In otherimplementations, body 112 may have other sizes and configurations thatallow it to move within a housing. User interface 114 is sized andshaped to allow a user to grasp it and to press on one of its ends 115to advance plunger 110 through housing 120. Plunger 110 also includesthreads 116, whose operation will be discussed in more detail below.Plunger 112 further includes a plunger adapter 118. Plunger adapter 118allows plunger 110 to interface with a number of plunger tips, whichwill be discussed below. The end of plunger adapter 118 distal from end115 includes a notch 119 for engaging (e.g., mating with) one or moreplunger tips.

Plunger chamber 130 is generally elongated and is cylindrical in theillustrated implementation. Plunger chamber 130 has a passage 132 sizedto allow body 112 of plunger 112 to pass therethrough. Plunger chamber130 also includes threads 134. Threads 134 are sized to mate withthreads 116 of plunger 110.

Plunger tip chamber 140 includes a cassette 142 that holds a firstplunger tip 180 and a second plunger tip 190. Cassette 142 is moveablelaterally relative to longitudinal axis 121. To move cassette 142,cassette 142 includes a tab 144 that extends outside of housing 120. Bypressing on tab 144, cassette 142 may be moved laterally (e.g., bysliding). Cassette 142 also includes a spring 146 that is compressed asfirst plunger tip 180 is moved towards lens chamber 150.

Lens chamber 150 is adapted to receive IOL 102 before a surgicalprocedure begins. Lens chamber 150 includes a cover 152 that may beopened to allow insertion of IOL 102. In particular implementations,cover 152 may allow IOL 102 to be inserted into lens chamber 150 beforeshipment. System 100 may then be cleaned, sterilized, and packaged forshipment. System 100 may therefore be a single-use (e.g., disposable)device. In other implementations, IOL 102 may be inserted in system 100shortly before use. Lens chamber 150 also includes a lens well 154 and atapered wall portion 156. Lens well 154 is adapted to receive IOL 102and hold it statically. Portions of the IOL 102 (e.g., haptics) may befolded upon insertion in lens well 154. Tapered wall portion 156 taperstoward insertion tip 170.

Delivery cartridge 160 is adapted to fold and compress IOL 102. In theillustrated implementation, delivery cartridge 160 has a circularcross-section and tapers towards insertion tip 170, although it couldhave other shapes (e.g., elliptical cross-section) in otherimplementations. Delivery cartridge 160 includes a chamber 162. Chamber162 has a lumen that connects lens chamber 150 to insertion tip 170 andgenerally tapers from lens chamber 150 to insertion tip 170. The lumenof chamber 162 may facilitate the folding and compression of IOL 102.

Insertion tip 170 is generally cylindrical in shape and is sized to fitthrough a surgical incision in an eye and allow IOL 102 to passtherethrough. In particular implementations, insertion tip 170 may fitthrough an incision of less than 2 mm.

First plunger tip 180 includes a body 182, a head 184, and a lensengagement tip 186. Body 182 is elongated and may be cylindrical inparticular implementations. Body 182 includes a portion 183 that taperstowards insertion tip 170. Tapered portion 183 is generally sized andshaped to match tapered wall portion 156 of delivery cartridge 150. Head184 is wider than body 182 and may also be cylindrical in particularimplementations. Head 184 is generally sized to reliably engage plunger110. Lens engagement tip 186 includes a generally sloping surface, whichassists in engaging and folding IOL 102. First plunger tip 180 may bemade of hard plastic, stainless steel, titanium, or any otherappropriate material.

Second plunger tip 190 also includes a body 192, a head 194, and a lensengagement tip 196. Body 192 is elongated and may be cylindrical inparticular implementations. In the illustrated implementation, head 194is narrower than body 192 and is cylindrical. However, in otherimplementations, the head 194 and/or the body 192 may have othercross-sectional shapes, e.g., elliptical. Head 194 includes a hub 195,which is sized to be received in notch 119 of plunger 110. Lensengagement tip 196 may be formed from a relatively compliant material.Body 192 and head 194 of second plunger tip 190 may be formed from amore rigid material. For example, the body 192 and the head 194 may beformed from a hard plastic, or other appropriate material. On the otherhand, the lens engagement tip 196 may be formed from a relatively softmaterial (e.g., silicone rubber). The lens engagement tip 196 may beassembled on or overmolded onto body 192.

FIGS. 2-6 illustrate the operation of system 100. In certain modes ofoperation, system 100 arrives with IOL 102 already inserted in lenschamber 150. Then, when a user (e.g., physician or other medicalprofession) is ready to use system 100 (e.g., after sedating thepatient, prepping the eye, and forming an incision in the cornea), theuser may apply a longitudinal force to end 115 of plunger 110. Plunger110 moves in response to the applied force along longitudinal axis 121towards insertion tip 170. Due this motion, plunger 110 moves firstplunger tip 180 along the longitudinal axis. Plunger 110 may or may nothave been previously engaged with first plunger tip 180. If notpreviously engaged, the motion of plunger 110 may cause the twocomponents to come into engagement.

As plunger 110 advances first plunger tip 180, lens engagement tip 186of first plunger tip 180 engages IOL 102 in lens chamber 150. Firstplunger tip 180 then advances IOL 102 into delivery cartridge 160 tofold the IOL 120. The advancement of first plunger tip 180 is stoppedafter it has traveled a predetermined distance. In some instances, theadvancement may be stopped when tapered portion 183 of first plunger tip180 engages tapered wall portion 156 of lens chamber 150, as best shownin FIG. 2. The stoppage may, for example, occur when IOL 102 has beensubstantially folded. In the illustrated implementation, IOL 102 hasadopted the lumen shape of the cartridge (e.g., the haptics and theoptic body are folded in a stable and desired orientation), butcompression has not yet begun.

The user may then reduce the force being applied to end 115 of plunger110. Reducing the force sufficiently allows spring 146 to retract firstplunger tip 180 in a second direction along longitudinal axis 121, whileleaving IOL 102 folded in delivery cartridge 160. Spring 146 may, forexample, cause first plunger tip 180 to substantially return to itsoriginal position in cassette 142, as shown in FIG. 3. In someimplementations, plunger chamber 130 may include a detent (e.g., a smalltab or ledge) to stop plunger 110 during the retraction.

The user may then engage tab 144 and move cassette 142 laterallyrelative to longitudinal axis 121. This movement disengages firstplunger tip 180 from plunger 110. Thus, the first plunger tip is nolonger aligned with longitudinal axis 121. The movement also alignssecond plunger tip 190 with longitudinal axis 121, as best seen in FIG.4. In some implementations, stops and/or locks may be used to controlthe movement of cassette 142 within the plunger tip chamber 140. Forexample, cassette 142 may engage (e.g., abut) portions of plunger tipchamber 140 to stop its motion. As another example, cassette 142 mayinclude spring-like members (e.g., arms and/or detents) that engage oneor more apertures recessed on the wall of plunger tip chamber 140.

The user may then apply a longitudinal force to end 115 of plunger 110.Plunger 110 again advances in response to the applied force alonglongitudinal axis 121 towards insertion tip 170. Due to this movement,notch 119 of plunger 110 mates with hub 195 of second plunger tip 190,as best shown in FIG. 5. Also due to this movement, lens engagement tip196 engages with IOL 102. IOL 102 may have been resting in a foldedstate in delivery cartridge 160. Plunger 110 may then move the IOL 102further into delivery cartridge 160, which further compacts (e.g.,compresses) the IOL 102.

After sufficient movement, threads 116 of plunger 110 will engage (e.g.,contact and/or mesh with) threads 134 of plunger chamber 130, as bestseen in FIG. 5. IOL 102 may still be located in delivery cartridge 160at this point. The user may then rotate user interface 114, which, afterthreads 116 and threads 134 mesh, will advance plunger 110 and, hence,second plunger tip 190 further towards the end of insertion tip 170, andresult in final compaction of IOL 102, as best seen in FIG. 6. Afterfurther movement of plunger 110 due to the rotation, IOL 102 will reachthe end of insertion tip 170 and be injected into an eye.

System 100 has a variety of features. For example, by being able to usea relatively hard plunger tip and a relatively soft plunger tip insequence, IOL 102 may be folded appropriately and still compressedsufficiently to fit through a small (e.g., less than 2.2 mm) tip. Thiseliminates or substantially reduces the risk of damage that may occur tothe IOL 102. Currently available soft-tipped plungers have thedisadvantage of not being able to providing a secure and controlled IOLfolding during early delivery stage, where a manual assistant IOLloading or folding is often needed for this kind of injector system.System 100, with two plungers concealed separately in the same device,incorporates the benefits of both a rigid-tip and soft-tip plunger atthe same time to reduce tip size and meet the demanding performancerequirements of micro-incision cataract surgery.

A variety of additions, deletions, substitutions, and modifications maybe made to system 100 and still achieve compaction of an intraocularlens. For example, plunger 110 may not include threads 116. Forinstance, the intraocular lens may be inserted by just applyinglongitudinal forces to end 115, which may allow easier one-handoperation. As another example, first plunger tip 180 may include a hubto engage notch 119 of plunger 110. As a further example, second plungertip 190 may not include a hub to engage notch 119. For instance, plunger110 may just engage head 194 by contacting the head 194. As anadditional example, plunger 110 may not include plunger adapter 118. Asanother example, plunger tip chamber 150 may include a lock to keepcassette 142 in place during transit and movement of first plunger tip180.

FIGS. 7A-7B illustrate a transverse cross-section of an example system200 for compacting an intraocular lens. Elements of system 200 may beusable with system 100.

System 200 includes a plunger chamber 210 and a plunger tip chamber 220.In general, plunger chamber 210 is adapted to allow a plunger (notviewable) to move therein to advance a first plunger tip 202 and asecond plunger tip 204 to engage and IOL. Plunger tip chamber 210 housesa cassette 230 that includes first plunger tip 202 and second plungertip 204.

Cassette 230 includes a body 232 that holds first plunger tip 202 andsecond plunger tip 204. Cassette 230 also includes a tab 234 thatextends from body 232 and arms 236 a, 236 b that extend from body 232.Tab 234 is adapted to be manipulated by a user and includes a detent235, as shown in FIG. 7A. Detent 235 is used to secure cassette 230 in afirst position in plunger tip chamber 220. Arms 236 a, 236 b are used tosecure cassette 230 in a second position, as shown in FIG. 7B.

Plunger tip chamber 220 includes a first aperture 222 and secondapertures 224 a, 224 b. First aperture 222 is sized to allow tab 234 toextend therethrough. Second apertures 224 a, 224 b are sized to allowarms 236 a, 236 b to extend thereinto.

In operation, cassette 230 is placed in the position shown in FIG. 7Abefore a surgical procedure (e.g., before shipping). In this position,first plunger tip 202, which may, for example, have a relatively hardtip, is aligned with the longitudinal axis of plunger chamber 210.Cassette 230 is held in this position by body 232 butting up against theinside of plunger tip chamber 220 and detent 235 engaging the outside ofthe plunger tip chamber 210. This arrangement holds first plunger tip202 in place so that a plunger may engage the first plunger tip 202appropriately.

When it is time to use second plunger tip 204, a user may engage tab 234and move it inwards into plunger tip chamber 220. Detent 235 may beovercome by applied physical force and/or by being manipulated aroundthe outside of plunger tip chamber 220 (e.g., by squeezing). As the usercontinues to move tab 234, body 232 moves so that arms 236 a, 236 bengage apertures 224 a, 224 b, as best seen in FIG. 7B. Arms 236 a, 236b may, for example, engage apertures 224 a, 224 b by springing intothem. When arms 236 a, 236 b engage apertures 224 a. 224 b, secondplunger tip 204 is aligned with the longitudinal axis of plunger chamber210. Thus, the plunger may now engage the second plunger tip 204.

Although FIG. 7 illustrates a system for compacting an intraocular lens,other systems for compacting an intraocular lens may include fewer,additional, and/or a different arrangement of components. For example, asystem may include a lens chamber, a delivery cartridge, and/or aninsertion tip. As another example, a system may not include one or morelocking mechanisms, e.g., detent 235 and/or arms 236 a, 236 b andcorresponding apertures 224 a, 224 b.

FIG. 8 illustrates an example process 800 for compacting an intraocularlens. Process 800 may, for example, be implemented by a system similarto system 100. Other lens compaction systems may also implement theprocess.

Process 800 calls for moving, in response to a force being applied in afirst direction along a longitudinal axis, a first plunger tip along thelongitudinal axis (operation 804). The movement may, for example, beaccomplished by a plunger that is moved in response to the appliedforce. The plunger may have been previously engaged with the firstplunger tip or may become engaged with the first plunger tip due to themovement. The first plunger tip may have a relatively hard end forengaging an intraocular lens.

Process 800 also calls for engaging an intraocular lens with the firstplunger tip (operation 808). The intraocular lens may, for example, bestored in a lens chamber. Process 800 additionally calls for moving theintraocular lens into a delivery cartridge to fold the intraocular lens(operation 812). In some instances, portions of the intraocular lens(e.g., haptics) may have already been folded upon insertion in the lenschamber.

Process 800 calls for stopping the first plunger tip after it hastraveled a predetermined distance (operation 816). The stoppage may, forexample, be accomplished by an interface between the delivery cartridgeand the first plunger tip. The stoppage may occur when the lens has beensubstantially folded.

Process 800 also calls for moving in a second direction along thelongitudinal axis in response to the applied force being reduced(operation 820). In some implementations, the applied force may bereduced to zero. The movement in the second direction may, for example,be caused by a resilient member (e.g., a spring) that has beencompressed during the movement in the first direction. Moving in asecond direction along the longitudinal axis in response to the appliedforce being reduced may include returning the first plunger tip to itsoriginal position (e.g., in a plunger tip chamber).

Process 800 additionally calls for disengaging from the first plungertip (operation 824). The disengagement may, for example, be accomplishedby moving the first plunger tip in a lateral direction relative to thelongitudinal axis. Thus, the first plunger tip may no longer be alignedwith the longitudinal axis. A cassette in a plunger chamber may, forexample, hold the first plunger tip, and movement of the cassette maycause the first plunger tip to move laterally.

Process 800 also calls for aligning a second plunger tip with thelongitudinal axis (operation 828). Aligning the second plunger tip may,for example, be accomplished by laterally moving a cassette holding thesecond plunger tip so that it is aligned with the longitudinal axis.

.

Process 800 also calls for engaging the second plunger tip (operation832). Engaging the second plunger tip may, for example, be accomplishedby mating with the second plunger tip. Process 800 additionally callsfor engaging the intraocular lens with the second plunger tip (operation836). The second plunger tip may have a relatively soft end for engagingthe intraocular lens. The intraocular lens may, for example, have beenresting in a folded state in the delivery cartridge. Process 800 alsocalls for moving the intraocular lens further into the deliverycartridge to compress the intraocular lens (operation 840).

Although FIG. 8 illustrates one implementation of a process forcompacting an intraocular lens, other processes for compacting anintraocular lens may include fewer, additional, and/or a differentarrangement of operations. For example, a process may additionally callfor moving, in response to a force being applied in the first directionalong the longitudinal axis, a plunger into position along thelongitudinal axis in anticipation of contact with the second plungertip. Additionally, a process for compacting an intraocular lens may alsoinclude, for example, locking a cassette holding the plunger tips in aposition in which the first plunger tip and/or the second plunger tip isaligned with the longitudinal axis. As another example, a process forcompacting an intraocular lens may include placing the lens in a lenschamber. As a further example, a process may not include stopping thefirst plunger tip after it has traveled a predetermined distance. Theadvancement of the first plunger tip may, for example, be stopped by auser ceasing to activate a plunger (e.g., in response to resistancegenerated by the intraocular lens). As a further example, a process mayinclude moving the folded, compressed intraocular lens through aninsertion tip to inject the intraocular lens into an eye. This movementmay, for example, be in response to a longitudinal force being appliedto the plunger or a rotational force being applied to the plunger.

The various implementations discussed and mentioned herein have beenused for illustrative purposes only. The implementations were chosen anddescribed in order to explain the principles of the disclosure and thepractical application and to allow those of ordinary skill in the art tounderstand the disclosure for various implementations with variousmodifications as are suited to the particular use contemplated. Thus,the actual physical configuration of components may vary. For example,the mentioned size(s) of components and their illustrated sizingrelative to each other may vary based on application. Moreover, theshapes of one or more components may vary depending on application.Thus, the illustrative implementations should not be construed asdefining the only physical size, shape, and relationship of components.

Various systems and processes for inserting an intraocular lens havebeen discussed, and several others have been mentioned or suggested.However, those skilled in the art will readily recognize that a varietyof additions, deletions, substitutions, and modifications may be made tothese systems and processes while still achieving insertion of anintraocular lens. Thus, the scope of protection should be judged basedon the following claims, which may capture one or more aspects of one ormore implementations.

1. An intraocular lens insertion system, the system comprising: a lenschamber adapted to receive an intraocular lens; a delivery cartridgecoupled to the lens chamber and adapted to fold and compress anintraocular lens as the intraocular lens is moved therethrough; aplunger adapted to be manipulated by a user; a plunger chamber adaptedto allow the plunger to be moved therein along a longitudinal axis andmove a plunger tip along the longitudinal axis; and a plunger tipchamber, the plunger tip chamber adapted to house a first plunger tipand a second plunger tip and to alternately switch between alignment ofthe first plunger tip and the plunger and alignment of the secondplunger tip with the plunger.
 2. The system of claim 1, wherein theplunger tip chamber is adapted to switch between the plunger tips byaltering which plunger tip is aligned with the longitudinal axis.
 3. Thesystem of claim 1, wherein the plunger tip chamber is laterally moveableso as to alternatingly align the first plunger tip and the secondplunger tip with the plunger.
 4. The system of claim 1, wherein theplunger tip chamber comprises a cassette adapted to hold the firstplunger tip and the second plunger tip and to move laterally within theplunger tip chamber to align alternatingly the first plunger tip and thesecond plunger tip with the plunger.
 5. The system of claim 4, whereinthe cassette is adapted to lock into a first position in which the firstplunger tip is aligned with the plunger and to lock into a secondposition in which the second plunger tip is aligned with the plunger. 6.The system of claim 1, wherein the plunger tip chamber comprises aspring adapted to compress when the first plunger tip is moved by theplunger and adapted to retract the first plunger tip and the plungerwhen the plunger is released.
 7. The system of claim 1, wherein theplunger is adapted to engage the first plunger tip via abutting contactand wherein the plunger is adapted to engage the second plunger tip viaan interlocking relationship.
 8. The system of claim 1, wherein the lenschamber is adapted to prevent advancement of the first plunger tipbeyond a predetermined distance
 9. The system of claim 8, wherein thepredetermined distance corresponds to a distance associated withsubstantially folding an intraocular lens.
 10. The system of claim 1,further comprising an insertion tip coupled to the delivery cartridgeand adapted to be inserted in an eye for injection of a folded,compressed intraocular lens.
 11. The system of claim 1, wherein thefirst plunger tip comprises a material having a first hardness and thesecond plunger tip comprises a material having a second hardness, andwherein the first hardness is substantially greater than the secondhardness.
 12. A method for inserting an intraocular lens, the methodcomprising: moving, in response to a force being applied in a firstdirection along a longitudinal axis, a first plunger tip along thelongitudinal axis and into a delivery cartridge to fold an intraocularlens; moving in a second direction along the longitudinal axis inresponse to the applied force being reduced; engaging a second plungertip; and moving, in response to a force being applied in the firstdirection along the longitudinal axis, the second plunger tip along thelongitudinal axis and into the delivery cartridge to compress theintraocular lens.
 13. The method of claim 11, wherein moving in a seconddirection along the longitudinal axis in response to the applied forcebeing reduced comprises returning the first plunger tip to a plunger tipchamber.
 14. The method of claim 11, wherein engaging a second plungertip comprises altering which plunger tip is aligned with thelongitudinal axis.
 15. The method of claim 13, wherein altering whichplunger tip is aligned with the longitudinal axis comprises laterallymoving the first plunger tip from being aligned with the longitudinalaxis and aligning the second plunger tip with the longitudinal axis. 16.The method of claim 14, wherein laterally moving the first plunger tipfrom being aligned with the longitudinal axis and aligning the secondplunger tip with the longitudinal axis comprises laterally moving acassette adapted to hold the plunger tips.
 17. The method of claim 15,further comprising locking the cassette in a position in which thesecond plunger tip is aligned with the longitudinal axis.
 18. The methodof claim 11, wherein moving in a second direction along the longitudinalaxis in response to the applied force being reduced comprisesdecompressing a spring.
 19. The method of claim 11, wherein engaging thesecond plunger tip comprises mating with the second plunger tip.
 20. Themethod of claim 11, further comprising stopping movement of the firstplunger tip in the first direction after the first plunger tip hastraveled a predetermined distance.